2022 Volume 55 Issue 5 Pages 309-317
Cancer is the third most common cause of death among dialysis patients in Japan. Nevertheless, there are no guidelines for the treatment of cancer in dialysis patients. This study aimed to examine the treatment of cancer in dialysis patients and non‒dialysis patients according to cancer stage in real‒world settings. In this multicenter retrospective cohort study, cancer registry data and administrative data were used to identify dialysis patients (n＝687) and non‒dialysis patients (n＝47900) aged 18‒79 years who were newly diagnosed with colorectal, stomach, or lung cancer between 2010 and 2015 at 36 hospitals in Osaka Prefecture, Japan. The records of these datasets were linked to obtain patient‒level information about dialysis treatment, cancer diagnoses, and cancer‒specific treatments. Dialysis patients were significantly more likely to undergo endoscopic resection and less likely to undergo surgical resection for early‒stage colorectal and stomach cancer than non‒dialysis patients. Dialysis patients were significantly more likely to receive radiotherapy for early‒stage lung cancer. Dialysis patients were significantly less likely to undergo combination treatment involving surgical resection and chemotherapy for colorectal, stomach, or lung cancer of any stage. Dialysis patients were significantly less likely to receive chemotherapy alone for distant recurrent stomach or lung cancer. Dialysis patients were significantly less likely to receive any treatment for lung cancer, regardless of its stage. In conclusion, dialysis patients were less likely to receive aggressive treatment for cancer than non‒dialysis patients. This study supports the development of evidence‒based practice guidelines for the treatment, particularly using chemotherapy, of cancer in dialysis patients.
